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Use of direct oral anticoagulants for postoperative venous thromboembolism prophylaxis after surgery for gynecologic malignancies
  1. Marilyn Boo1,
  2. Peter Sykes1,2 and
  3. Bryony Simcock1
  1. 1Gynaecologic Oncology, Christchurch Women's Hospital, Christchurch, New Zealand
  2. 2University of Otago Christchurch, Christchurch, New Zealand
  1. Correspondence to Dr Marilyn Boo, Gynaecologic Oncology, Christchurch Women's Hospital, Christchurch 8011, New Zealand; marilynbooma379{at}


Venous thromboembolism is a preventable cause of postoperative mortality in patients undergoing surgery for malignancy. Current standard of care based on international guideline recommends 28 days of extended thromboprophylaxis after major abdominal and pelvic surgery for malignancies with unfractionated heparin or low molecular weight heparin. Direct oral anticoagulants have been approved for the treatment of venous thromboembolism in the general population. This regimen has a significant advantage over other types of anticoagulation regimens, particularly being administered by non-parenteral routes and without the need for laboratory monitoring. In this review, we evaluate the role of direct anticoagulation and provide an update on completed and ongoing clinical trials.

  • venous thromboembolism
  • embolism
  • surgical oncology
  • postoperative Care
  • gynecologic surgical procedures

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  • Contributors MB: main author of narrative review. PS: supervisor and co-contributor. BS: supervisor and co-contributor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.